Strabismus (Cross-Eyes)

Overview

What is strabismus and how do I know if my baby has it?

Strabismus (say: “stra-biz-muss”) is a disorder in which the eyes do not line up properly. Instead, the eyes appear to cross, or one eye may wander to the side.

Why is strabismus a problem?

For normal vision, both eyes need to look in the same direction at the same time. When a child has a crossed or wandering eye, he or she gets a different picture from each eye. The child’s brain naturally tries to fix this problem by blocking out the picture from the weaker eye. If strabismus is not fixed when a child is young, the child’s brain will always ignore the pictures from the weak eye. This kind of vision loss is called amblyopia (say: “am-blee-o-pee-ah”). It is the most serious problem caused by crossed or wandering eyes.

Symptoms

When should I be concerned about my child’s crossed eyes?

It’s normal for newborn babies to have eyes that cross or wander sometimes, especially when they’re tired. However, if your child is older than 3 months of age, tell your doctor if you see your child’s eyes cross or wander, even if it happens only once in a while. Also tell your doctor if your child often looks at you with one eye closed, or with his or her head turned to one side.

Treatment

What can be done to fix strabismus?

After time, treatment can help your child have normal vision. The earlier the treatment starts, the better.

The goal of treatment is to make the weak or wandering eye do more work and get stronger. This could mean that the child has to wear corrective glasses. Or the child might wear a patch on or have eye drops put in the “good” eye, forcing the weaker eye to work harder. Your child may not like to have these treatments because at first the weak eye doesn’t see as well as the other eye. Even if your child doesn’t want to wear glasses or an eye patch, the treatment is very important. It can help your child see better as a child and as an adult.

Some children need an operation to straighten their eyes. The operation is usually considered only after using the treatments listed above. The surgery is fairly simple, but it doesn’t always make the eyes exactly straight. Sometimes it has to be performed again later on.

How long does treatment last?

The earlier treatment starts, the easier it is to fix the problem. So watch for signs that your child doesn’t see well, or for eyes that cross or wander apart. Usually, treatment will go on for months or even a few years. Sometimes less patching (or fewer eye drops) will be needed as time goes by. Since the most important part of treating strabismus is to force the weak eye to work harder, it’s very important that you follow your doctor’s directions for eye patching or eye drops. If you have questions, always ask your family doctor.

Questions to Ask Your Doctor

  • Will my child’s eyes always be crossed?
  • Are there exercises I can do with my child that will help to make his or her eye muscles stronger?
  • Will my child have to wear glasses?
  • Should I take my child to see an eye doctor regularly?
  • If my child has cross-eyes, will he or she have other eye problems later in life?

Citations

  • Pediatric Vision Screening for the Family Physician by P Broderick( 09/01/98, http://www.aafp.org/afp/980901ap/broderic.html)